Case Report

J Rheum Dis 2014; 21(6): 326-330

Published online December 30, 2014

© Korean College of Rheumatology

Leflunomide-induced Toxic Epidermal Necrolysis in a Patient with Rheumatoid Arthritis

Ji Hye Je, Hyun Jung Lee, Young Ju Na, Ji Hye Seo, Young Ho Seo, Jae-Hoon Kim, Sung Jae Choi, Young Ho Lee, Jong Dae Ji, Gwan Gyu Song

Division of Rheumatology, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea

Correspondence to : Sung Jae Choi

Received: November 11, 2013; Revised: March 3, 2014; Accepted: March 7, 2014

Abstract

Leflunomide was licensed for the treatment of rheumatoid ar-thritis in 1998 and has been available in Korea since 2003. Allergic cutaneous reactions (rash, purpura) are common (<10%) side effects of leflunomide, but severe cases such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) are rarely reported. There has not been a report of SJS or TEN induced by leflunomide in Korea. Here we report a case of leflunomide-induced TEN in a patient with rheuma-toid arthritis. Leflunomide was discontinued, and the TEN was treated with methylprednisolone, cholestyramine and immunoglobulin. The skin lesion eventually resolved over four weeks with residual post-inflammatory hyperpigmentation.

Keywords Leflunomide, Toxic epidermal necrolysis, Rheumatoid arthritis

Article

Case Report

J Rheum Dis 2014; 21(6): 326-330

Published online December 30, 2014

Copyright © Korean College of Rheumatology.

Leflunomide-induced Toxic Epidermal Necrolysis in a Patient with Rheumatoid Arthritis

Ji Hye Je, Hyun Jung Lee, Young Ju Na, Ji Hye Seo, Young Ho Seo, Jae-Hoon Kim, Sung Jae Choi, Young Ho Lee, Jong Dae Ji, Gwan Gyu Song

Division of Rheumatology, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea

Correspondence to:Sung Jae Choi

Received: November 11, 2013; Revised: March 3, 2014; Accepted: March 7, 2014

Abstract

Leflunomide was licensed for the treatment of rheumatoid ar-thritis in 1998 and has been available in Korea since 2003. Allergic cutaneous reactions (rash, purpura) are common (<10%) side effects of leflunomide, but severe cases such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) are rarely reported. There has not been a report of SJS or TEN induced by leflunomide in Korea. Here we report a case of leflunomide-induced TEN in a patient with rheuma-toid arthritis. Leflunomide was discontinued, and the TEN was treated with methylprednisolone, cholestyramine and immunoglobulin. The skin lesion eventually resolved over four weeks with residual post-inflammatory hyperpigmentation.

Keywords: Leflunomide, Toxic epidermal necrolysis, Rheumatoid arthritis

JRD
Jan 01, 2025 Vol.32 No.1, pp. 1~7
COVER PICTURE
Cumulative growth of rheumatology members and specialists (1980~2024). Cumulative distribution of the number of the (A) Korean College of Rheumatology members and (B) rheumatology specialists. (J Rheum Dis 2025;32:63-65)

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